- Handbook on the Physics of Diagnostic Radiology, 2014 (IAEA)
- Optimization in Mammography, TECDOC 1447, 2005 (IAEA)
- Training Materials on Optimization and Diagnostic Imaging (IAEA RPoP website)
- Managing Patient Doses in Digital Radiology, Publication 93, 2004 (ICRP)
- Managing Patient Doses in Digital Radiology (ICRP) - additional slides
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The goal of optimization is to balance the image quality required for diagnostic purposes with the appropriate radiation dose to the patient. In addition, this balance includes possible contract effects, RF heating (for MRI examinations), examination time, and other patient related factors. Optimization is the key to quality medical imaging procedures.
Optimization starts with an audit of image quality and radiation doses throughout the department. This should be done on a room-by-room basis since doses, and quality, can vary significantly from room-to-room. The first areas to address are those where doses exceed diagnostic reference levels, followed by those exceeding achievable dose levels.
All optimization processes require a team approach including the radiologist responsible for the area, the supervising radiographer, the medical physicist, and possibly a service engineer. Each brings their own experience and expertise to the process and as a team can provide insight not available from individuals.
Imaging protocols and equipment configurations should be reviewed for appropriateness. The reading room should be reviewed for appropriate viewbox and display luminance levels, and ambient lighting.
All factors not meeting benchmark data should be corrected. After implementation the process should be repeated to determine the effectiveness of the optimization process.
Introduction to References
There is a significant amount of information in the literature illustrating optimization examples in medical imaging. Many references are provided in the Essential and Supplemental References.